Individualized peri-operative fluid therapy facilitating early-phase recovery after liver transplantation

Table 1 Comparison of 25 variables between the groups with and without pulmonary complications

Variables	Non-pulmonary complication group (n = 55)	Pulmonary complication group (n = 47)	P value
Age (yr)	46.29 ± 9.14	44.06 ± 9.95	0.242
Weight index (kg/m2)	22.78 ± 3.35	22.36 ± 3.29	0.531
Hb (g/L)	122.79 ± 21.12	109.54 ± 25.25	0.005
HCT (%)	36.21 ± 6.42	32.53 ± 7.53	0.009
CRE (mmol/L)	83.75 ± 21.35	85.96 ± 23.88	0.623
BUN (mmol/L)	4.70 ± 1.92	5.22 ± 3.09	0.323
UA (mmol/L)	303.76 ± 113.27	272.43 ± 117.94	0.175
ASA grade	2.76 ± 0.61	3.0 ± 0.75	0.082
Child-Pugh score	7.29 ± 2.40	8.38 ± 2.88	0.039
APACHE II score	3.95 ± 2.47	4.79 ± 3.53	0.174
MELD score	14.22 ± 7.34	16.68 ± 9.39	0.140
Warm ischemia time (min)	5.80 ± 1.52	5.53 ± 1.63	0.392
Cold ischemia time (min)	710.13 ± 184.99	654.21 ± 208.25	0.154
Anhepatic phase (min)	123.04 ± 34.46	126.00 ± 47.00	0.715
Operative time (min)	423.22 ± 84.92	489.38 ± 150.00	0.009
Diabetes (%)	9.09	8.51	1.000
Lung dysfunction (%)	12.73	19.15	0.374
Volume of intra-operative blood transfusion > 30 mL/kg (%)	65.45	82.98	0.046
Volume of intra-operative packed RBC transfusion > 0.05 U/kg (%)	76.36	91.49	0.041
Volume of intra-operative plasma transfusion > 25 mL/kg (%)	43.64	63.83	0.042
Volume of intra-operative fluid transfusion > 100 mL/kg (%)	58.18	80.85	0.014
Volume of intra-operative bleeding > 10 mL/kg (%)	67.27	87.23	0.018
Intra-operative fluid balance > 64 mL/kg (%)	32.73	53.19	0.037
a (%)	21.82	4.26	0.010
b (%)	38.18	17.02	0.018
c (%)	25.45	6.38	0.010
d (%)	72.73	68.09	0.612
e (%)	36.36	14.89	0.014

Hb: Hemoglobin; HCT: Hematocrit; CRE: Creatinine; BUN: Blood urea nitrogen; UA: Serum uric acid; ASA: American Society of Anesthesiologists; APACHE: Acute physiology and chronic health evaluation; MELD: Model for end-stage liver disease. a, transfused volume on the first post-operative day ≤ 44 mL/kg; b, fluid balance on the first post-operative day ≤ -14 mL/kg; c, fluid balance ≤ -14 mL/kg on the first day and the second or the third day after operation; d, fluid balance ≤ -14 mL/kg on ≥ 1 d of the first 3 d after operation; e, fluid balance ≤ -14 mL/kg on ≥ 2 d after operation. ASA grade I was assigned a score of 1, grade II was assigned a score of 2, grade III was assigned a score of 3, and grade IV was assigned a score of 4. Mean ± SD was used for continuous variables, otherwise percentage was used (%).

Table 2 Summary of the logistic regression model and odds ratios

Variables	Beta	SE	Sig	Exp (B)	95% CI
Hb	-0.025	0.010	0.11	0.975	0.956-0.994
Volume of intra-operative transfusion	1.097	0.496	0.27	2.995	1.132-7.922
c	2.037	0.722	0.05	7.670	1.862-31.603

SE: Standard error; Sig: Statistical significance; CI: Confidence interval; Hb: Hemoglobin. c, fluid balance ≤ -14 mL/kg on the first day and the second or the third after operation. When the volume of intra-operative transfusion ≤ 100 mL/kg, the variable was assigned a score of 0, and when the variable > 100 g/L, the variable was assigned a score of 1.

Table 3 Comparison of outcome variables reflecting post-operative recovery between groups A and B

	Group A(n = 32)	Group B(n = 70)	Z or t	P value
Extubation time (h)	12/8-99	16.5/5-504	-2.779	0.005
Time to initial passage of flatus (h)	78.66 ± 21.05	90.51 ± 45.28	-1.411	0.161
ICU length of stay (h)	36.5/8-144	62/14-600	-4.173	0.000

Values are given as the mean ± SD (median/range). ICU: Intensive care unit.

Table 4 Comparison of outcome variables reflecting post-operative recovery between groups A and B

	Group A(n = 17)	Group B(n = 85)	Z or t	P value
Extubation time (h)	12/7-32	15/5-504	-2.708	0.007
Time to initial passage of flatus (h)	59.71 ± 12.17	92.21 ± 40.96	-6.094	0.000
ICU length of stay (h)	40/13-219	60/8-600	-1.590	0.112

Values are given as the mean ± SD (median/range). ICU: Intensive care unit.

Table 5 Comparison of the worst outcome of arterial blood gas in the first 7 post-operative days between groups A and B

	Group A (n = 17)	Group B (n = 85)	t	P value
PH	7.436 ± 0.041	7.437 ± 0.055	-0.108	0.914
PaO2	117.471 ± 31.283	92.722 ± 30.105	3.075	0.003
PaCO2	44.094 ± 7.168	44.787 ± 12.038	-0.229	0.819
BE	4.459 ± 4.207	4.789 ± 4.062	-0.305	0.761
PaO2/FiO2	295.891 ± 92.741	224.243 ± 81.820	3.223	0.002

Values are given as the mean ± SD. PH: Power of hydrogen; PaO₂: Arterial partial pressure of oxygen; PaCO₂: Arterial pressure of carbon dioxide; BE: Base excess.